Director of Compliance

RHA Health Services • Nashville, TN

2d

About The Position

If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services! The Director of Compliance directs day-to-day operations of the enterprise Compliance Program and serves as a key leader to the Chief Compliance Officer. This role oversees the privacy program, sanction/exclusion screening, investigations, policy management, and compliance reporting while building and sustaining an effective program aligned to OIG elements, HIPAA/HITECH, state HCBS/IDD requirements, and payer rules across multiple states. It expands on existing responsibilities for hotline management, sanction checking, investigations, policy/procedure oversight, conflict-of-interest disclosures, annual training planning, privacy program leadership, and compliance analytics/reporting.

Requirements

• Bachelor’s degree required (Business, Healthcare Administration, Public Health, Nursing, Legal/Compliance, or related field).
• 5+ years of progressive experience in healthcare/HCBS compliance, including investigation oversight and policy management.
• Strong knowledge of HIPAA/HITECH, federal/state healthcare and HCBS regulations, FWA standards, exclusion screening, conflicts governance, and privacy incident management.
• Demonstrated ability to manage hotlines, conduct/oversee investigations, and produce clear, objective reports.
• Proficiency with compliance case-management and analytics/reporting tools; advanced writing, facilitation, and stakeholder-influence skills.

Nice To Haves

• Multi-state IDD/behavioral health or long-term services and supports experience; payer/Medicaid waiver familiarity preferred
• Experience presenting to executive/Board audiences and working within a three-lines-of-defense or ERM structure preferred.
• Periodic travel to sites and state program offices as needed.

Responsibilities

• Program Leadership & Governance
• Operationalize and continuously improve an enterprise Compliance Program aligned to OIG’s seven elements (standards, oversight, education, communication, auditing/monitoring, enforcement/discipline, response/prevention).
• Maintain the Compliance Charter, annual work plan, and a written standards/code of conduct; ensure consistent deployment across all states and service lines.
• Coordinate the enterprise compliance risk assessment and translate results into prioritized mitigation plans and monitoring.
• Policies, Education, and Communications
• Own the lifecycle (draft/review/approve/archive) of Compliance and Privacy policies, SOPs, and document-retention standards; ensure alignment to federal/state HCBS waiver, Medicaid/Medicare, and commercial payer requirements.
• Define the annual training strategy and calendar; develop role-based education (general compliance, HIPAA privacy/security basics, fraud/waste/abuse, conflicts, documentation standards).
• Maintain accessible FAQs, toolkits, and targeted communications to reinforce standards and lessons learned.
• Hotline and Compliance Investigations Support
• Support confidential reporting channels (hotline, web, internal reports) by ensuring proper intake, triage, and documentation in alignment with established protocols.
• Assist in compliance investigation processes by coordinating case information, maintaining records, and ensuring timely escalation of matters as needed.
• Monitor case progress for adherence to protocols such as retaliation-prevention, documentation standards, and closure requirements.
• Manage compliance platforms (e.g., Resolver, Diligent, or other designated systems), ensuring data integrity, reporting accuracy, and user access controls.
• Track and summarize trends, case metrics, and system usage to support compliance oversight and reporting needs.
• Sanction/Exclusion Screening & Conflicts of Interest
• Oversee OIG/GSA/state Medicaid exclusion screening for employees, contractors, and vendors; ensure timely remediation of matches and documentation.
• Administer the annual Conflict-of-Interest disclosure process and manage follow-ups, mitigation, and Board/leadership reporting.
• Privacy & Security Collaboration
• Lead the operational Privacy Program (in partnership with Security/IT): incident intake, assessment, breach determination/notifications, mitigation, and prevention education.
• Ensure Business Associate Agreement governance, minimum necessary standards, and PHI safeguarding practices; coordinate with InfoSec on incidents that intersect privacy/security.
• Auditing, Monitoring, and Analytics
• Build an annual audit/monitoring plan (documentation standards, billing/claims risk areas, exclusion screening, training completion, policy adherence).
• Deploy dashboards and KPIs for leadership and oversight committees (e.g., hotline volumes, time-to-first-action, time-to-closure, trends by region, training completion, policy exceptions).
• Validate corrective action effectiveness and sustainment; escalate unresolved risks.
• Regulatory & Payer Interface
• Coordinate responses to government inquiries, surveys, and audits; manage timely external notifications when required by law/regulation or payer contract.
• Maintain a regulatory calendar (reportable events, timelines, renewal/attestation dates) and ensure state-specific requirements are met for IDD/behavioral health, HCBS, residential/day programs, and healthcare facilities.
• Committees, Reporting, and Culture
• Prepare materials and present to the Management Compliance Committee and Compliance Steering Committee; support Board-level reporting through the CCO.
• Promote a just-culture approach, psychological safety, and non-retaliation; partner with Operations and Quality/Risk to share “lessons learned.”
• Third-Party & Acquisition Support
• Oversee compliance due diligence and onboarding for acquisitions/affiliations; align policies, training, and exclusion screening pre- and post-close.
• Support vendor compliance (contract language, BAAs where applicable, right-to-audit, performance and sanction checks).
• Other
• Perform other duties as assigned.

Benefits

• Payactiv: early access to the money you’ve earned from hours you’ve already worked, before payday!
• Employee perks and discount program : to help you save money!
• Paid Time Off (full-time employees only)
• Health/Insurance (full-time employees only)
• 401(k) retirement savings program
• Wellbeing Programs: Physical, Emotional and Financial
• Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
• Training: Free CPR, first aid, and job-specific training opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Director